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Pain Management for Breast Cancer

The majority of breast cancer graduates will experience some level of pain. It is important to acknowledge that everyone experiences pain differently, and so a personalized pain management for breast cancer plan is important.
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Credit: after Breast Cancer

According to the National Cancer Institute, cancer pain can be managed effectively in up to 90% of people who have cancer or have been treated for it in the past. Yet many people do not get adequate treatment for their pain, often because they are afraid to bring it up or their doctors never do. Be assured that most people can expect significant or complete relief from pain that will allow you to continue to enjoy the activities of daily life. The process may take time to identify the right combination of pain treatment but you taking the time to put the effort into this will be worth it.

Types of Pain

There are three main types of pain: acute, chronic, or breakthrough.

Acute Pain
Acute pain is intense, comes on suddenly which limits your activities almost immediately. This type of pain typically is caused by an injury or surgery. However, it will typically reduce once the body heals.

Chronic Pain
Chronic pain is pain that lasts for longer periods of time. It can sometimes be experienced as a background ache or a more intense feeling where it is impossible to focus on the day-to-day. This type of pain typically has a greater impact on quality of life than acute pain. Persistent pain is generally treated with sustained release medications that will slowly be released into the body to control pain for a longer period of time. These will need to be proactively managed on a regular basis to maintain a constant level of pain relief rather than play catch up when you feel pain.

Breakthrough Pain
Even when chronic pain is well controlled with regular doses of pain medication, you may experience breakthrough pain. This is a sudden, intense onset of pain that breaks through current pain management techniques. Treatment for breakthrough pain involves taking short-acting pain medicines as soon as you notice the pain breaking through.

Causes of Pain

If you're just starting treatment for breast cancer, it can be hard to tell the difference between pain caused by the cancer itself, pain caused by treatments and any pain that is of concern. However, if you experience an unusual pain that persists, be sure to have it checked out by your doctor.

Cancer Pain
Pain caused by the breast cancer may come from the tumour in the breast. It’s actually not common to experience pain as a symptom of early breast cancer, but you may experience pain as the tumour pushes into the healthy tissue. For women with inflammatory breast cancer, pain or tenderness often is one of the first symptoms. A rare form of breast cancer called Paget's disease of the nipple can cause pain and burning as an early symptom, along with nipple irritation.  Those with metastatic or advanced cancer more commonly experience pain caused by the cancer itself. If you've already completed treatment for breast cancer, it can feel very disconcerting to experience pain in the affected breast or your other breast. Breast pain can be a due to a variety of reasons but new and persistent discomfort in only one breast may be of concern. This is especially true if the pain is worsening without any reason. Book an appointment with your doctor for ease of mind.

Treatment-Related Pain
Treatments for breast cancer can cause side effects that are uncomfortable or painful. However, don't let fear about the possibility of pain keep you from getting the treatments you need.

Pain Medications and Other Pain-Reducing Therapies

When it comes to breast cancer-related pain, no two people are exactly alike. A cancer treatment that causes little or no pain for one person may cause intense pain for another. Work with your pain management for breast cancer team to figure out the best pain control plan for you and adjust it over time as needed. Pain management for breast cancer includes medications and therapies such as:

  • Non-Narcotic Analgesics (Non-Opioids)
  • Narcotic Analgesics (Opioids)
  • Co-analgesics for Pain
  • Surgery, Radiation Therapy, Chemotherapy, or Hormonal Therapy for Pain
  • Physical Therapy for Pain
  • Complementary and Holistic Medicine for Pain
  • Topical Analgesics
  • Nerve-Blocking Strategies
  • Nerve Stimulation

For the majority of patients, medications will be a central part of the treatment plan for pain management for breast cancer. In order to get the most benefit from your medications, here are some doctor-approved tips:

  1. Take your pain medicine on a regular schedule to help control pain rather than wait until it is unbearable
  2. If you have breakthrough pain, use your short-acting medicine as your doctor suggests.
  3. Try to ensure that only one doctor prescribes your pain medicine and ensure any new doctors understand your treatment plan prior to prescribing or changing your medication.
  4. Give yourself time to get repeat prescriptions to ensure you don't run out of pain medicine early.
  5. Everyone reacts to pain medicines differently so make sure your dosage & treatment plan is working for you.
  6. Don’t be afraid to ask for a change and be honest about the pain you are experiencing. Remember, your pain management for breast cancer plan can be changed at any time

Keeping a Pain Diary for Pain Management for Breast Cancer

Keeping a pain diary can help your doctors and nurses develop the best pain management for breast cancer plan for you. Regular diary entries will help you and your doctor assess your pain, identify patterns, and evaluate how well medications or other treatments are working. Therefore, each time you feel pain, record the following:

  • Date and time you experienced the pain
  • Where in your body you experience the pain
  • A description of the intensity and type of pain
  • How long the pain lasts
  • What activity is making it worse or better, and when it flares or lessens
  • Details of any medication or pain relief strategies you took to relieve the pain and whether it worked

Communicating with Your Doctors about Pain

It can take some trial and error to find the right pain medications and other therapies and get them working well for you. The nature of your pain can change over time, and this may require a change in your treatment. Use your pain diary to help you and make a list of topics you wish to discuss. It is easy to forget to discuss pain management for breast cancer when you and your doctor are focused on the details of your treatment and recovery. Make sure you talk about the side effects. Ask for ways to prevent or treat any side effects of your pain medication and which side effects might warrant a call to your doctor. It’s so important to speak up if your pain control plan is not working. Communicate with your doctor if your pain isn't getting better or going away, or if your pain medicine does not work as quickly or as long as your doctor said it would.

Working With a Pain Management for Breast Cancer Team

Many hospitals and medical centers now have pain management programs, also called palliative care. These are staffed by a range of healthcare professionals specialized in assessing and treating pain. Palliative care is for anyone who needs help due to the physical pain, as well as the stress and anxiety, which cancer can cause.

Managing the Psychological Effects of Pain

Finally, pain can affect you not only physically, but also mentally and emotionally. Pain can cause some people to feel anxious and out of control at times. You can take control by telling your care team about any pain you experience and asking for the treatment you need. Moreover, you also may benefit from complementary and holistic techniques that focus on promoting a sense of relaxation and calmness, such as:

If at any point you feel overwhelmed by depression or anxiety, talk to your doctor. They will certainly be able to guide you in getting the right help with these feelings while also relieving pain and improving any sleep concerns. You may find it helpful to meet with a counsellor, therapist, or psychiatrist who specializes in cancer patients. Remember to reach out to your healthcare team if you are concerned about your pain. They can help you navigate your pain management for breast cancer options. after BREAST CANCER focuses on the women who have survived, women who don’t have insurance, women who cannot have their basic needs met after a mastectomy or lumpectomy surgery. If you need support, please click here.

This article was published with permission from after Breast Cancer in the Great West Media Think Pink special feature. Click here to learn more about the organization after Breast Cancer.

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